Electrically operated surgical equipment has various controls to adjust different functions and output characteristics of the equipment. For instance, activating an electrosurgical generator by depressing a foot switch causes electrical energy to be delivered to the tissue. The amount of power delivered and the characteristics of the power delivered are selected and adjusted from front panel controls, to cut the tissue, coagulate blood flow from the tissue, or simultaneously cut and coagulate. Other types of surgical equipment have similar activation and control characteristics as well as similar front panel controls.
The front panel controls of the surgical equipment cannot be positioned within the sterile field where the surgeon is operating because it is not possible to disinfect and sterilize the entire surgical equipment of which the front panel controls are a part. Instead, the surgeon must rely on an assistant to make adjustments to the front panel controls, and that assistant must remain outside of the sterile field. Adjustments to the front panel controls are achieved in response to verbal commands from the surgeon, and such verbal communication may be prone to misinterpretation. In any event, the necessity to rely on an assistant for indirect control over non-sterile surgical equipment can become a distraction to the surgeon, particularly in procedures which require numerous adjustments during the course of the procedure.
Each surgeon typically has preferred settings for the surgical equipment, to give the best results for a particular type of surgical procedure in accordance with the surgeon's particular manner of performing the procedure. The preferred settings must be remembered and established before beginning the procedure. Failing to establish or remember the preferred settings can require additional adjustments to be made during the procedure and is distracting to the progress of the procedure.
Foot switches are located underneath the operating table upon which the patient is placed for the procedure. The foot switches are therefore located outside of the sterile field. However, foot switches are relatively bulky and heavy and are connected to the surgical equipment by a cable that extends along the floor. Foot switches and their cables can clutter the floor of an operating room, particularly when more than one foot switch is used. The foot switches and their cables may pose a tripping hazard that can be especially distracting to the numerous people working and moving about the operating table. Even though they are located outside of the sterile field, foot switches and their cables are a potential source of introducing pathogens into the operating room.
It is not unusual for two different surgeons to use the same surgical equipment in an alternating manner during the course of a procedure. In this situation, the foot switch must be moved between different positions where the two surgeons can reach it. Moving the foot switch back and forth in this manner is difficult due to its bulk and because the cable extending from the foot switch further complicates movement. Moving the foot switch is time consuming, inconvenient and inefficient because of the delay involved in moving and positioning the foot switch. Moreover, an assistant operating outside of the sterile field must be used to position the foot switch. When the foot switch is moved, or when the surgeon shifts his or her position, the surgeon may experience difficulty in locating the position of the foot switch for use, thereby distracting attention from the procedure.
One approach to dealing with some of these problems utilizes a holograph to project an image of the controls for the surgical equipment into empty three-dimensional space within the operating room. When an object enters the three-dimensional space in which the holographic image of the controls is located, an adjustment to the equipment is made. Allowing the surgeon to interact with a holographic image allows the surgeon to establish direct control over the surgical equipment without compromising the sterile field, but holographic images introduce new problems. One such problem stems from the fact that holographic images can only be viewed from a relatively narrow field of vision, which means that they cannot always be seen by the surgeon. For the surgeon to view the holographic controls, the light projection equipment that creates the hologram has to be adjusted in a particular location in the operating room, or the surgeon must shift his or her position at the operating table, or the surgeon must again rely on an assistant to interact with the hologram to achieve control over the surgical equipment. Moreover, because the hologram exists in three-dimensional space, an individual or object can inadvertently move through the three-dimensional space and interact with the hologram in such a way to create an unintended adjustment of or control over the surgical equipment.
The holographic controls for surgical equipment do not effectively deal with the problem of clutter caused by the bulky foot switches and their attached cables beneath the operating table. Holographic controls can not be conveniently located near the floor because of the necessity to focus the holographic image at a location where interaction with it is possible.
Another circumstance which may result in distraction or inconvenience to the surgeon during the procedure relates to informing the surgeon of various physiological and other conditions of the patient during the procedure. It is typical that monitoring equipment is connected to the patient during the surgical procedure to monitor the condition of the patient. Such patient monitoring equipment typically includes integrally connected monitors and displays which present the information describing the condition of the patient. These monitors and displays are large and complex devices and are sometimes integrated with the patient monitoring equipment itself, thereby making it essentially impossible to sterilize this equipment. Consequently, the patient monitoring equipment and associated display devices must therefore remain outside of the sterile field and outside of the direct view and observation of the surgeon while performing the procedure at the surgical site.
The surgeon must rely on an assistant to communicate verbally the relevant patient condition information or to alert the surgeon of the necessity to divert his attention from the surgical site to view a monitor or display located elsewhere within the operating room. Periodically diverting the surgeon's attention away from the surgical site is a distraction and a complication to the surgeon, particularly in very intense and tedious procedures. Relying on an assistant to communicate relevant patient information to the surgeon is subject to miscommunication and misinterpretation.
A similar situation exists with respect to information describing the performance of the surgical equipment. In those circumstances where the surgeon wishes to observe a performance characteristic of the surgical equipment, such as the total amount of electrical energy delivered to the patient during a particular length of time or during an activation time interval of the surgical equipment, the surgeon must divert his attention from the surgical site to view a display or monitor associated with the surgical equipment. The need to continually divert attention from the surgical site is an inconvenience and distraction. In some procedures, the surgeon must focus intently on the procedure at the same time that the surgeon desires to observe and evaluate the performance of the surgical equipment. However, since the surgeon cannot divert his or her attention from the surgical site, it becomes impossible to simultaneously monitor the performance of the surgical equipment while using that surgical equipment.